Effect Of Nocturnal Hypoxia On Serum VEGF And Ki67 Expression In Patients With Advanced NSCLC And Its Clinical Significance

Objective:To investigate the effect of nocturnal hypoxia on the expression of serum VEGF and Ki67 in patients with advanced NSCLC and its clinical significance.Method:Sixty-four newly diagnosed and untreated with advanced non-small cell lung cancer(NSCLC)patients by histopathology were monitored by watch-type oxygen saturation monitor.They were divided into nocturnal hypoxia group and non-night hypoxia group according to the monitoring results.The expression of Ki67 protein in lung cancer tissues was detected by immunohistochemistry.Serum levels of vascular endothelial growth factor(VEGF)were measured by enzyme-linked immunosorbent assay(ELISA).Compared the difference of Ki67 positive rate and s VEGF level between the two groups,and analyzed the effects of nocturnal hypoxia on Ki67 positive rate and sVEGF level,and discussed their relationship with clinical parameters.Result:1.The incidence of nocturnal hypoxia was 45.3%(29/64)in advanced NSCLC patients.The nighttime blood saturation has significant difference between the two groups(P=0.000)and between the mild,moderate,severe nocturnal hypoxia groups(P<0.05).The nocturnal hypoxia was not significantly correlated with age,gender,pathological type,TNM stage and distant metastasis(P>0.05),but smoking(P=0.027)or gross type(P=0.031).Patients who smoke or with central lung cancer were more likely have nocturnal hypoxia than non-smoking or peripheral lung cancer patients.2.The difference of sVEGF level and Ki67 positive rate between the two groups was statistically significant(P=0.00).The positive rate of sVEGF and Ki67 in the hypoxia group was higher than that in the non-nocturnal hypoxia group.3.The level of sVEGF had no correlation with gender,age,smoking,pathological type,general type and TNM stage(P>0.05),but was significantly correlated with distant metastasis(P=0.00),the sVEGF levels of patients with distant metastasis were higher than those without.The Ki67 positive rate had no significant correlation with all the clinical parameters above.4.Correlation analysis Pearson correlation analysis showed that there was positively correlation between sVEGF level and Ki67 positive rate.Conclusion:1.Hypoxia at night can promote the expression of VEGF and Ki67 in cancer cells of patients with advanced NSCLC.2.A significant increase in sVEGF in patients with advanced NSCLC may suggest a metastatic presence.3.The positive rate of Ki67 in advanced NSCLC patients was positively correlated with sVEGF,which may play a synergistic role in the development and progression of lung cancer.